Phytophotodermatitis in Adult
Alerts and Notices
Synopsis

Phytophotodermatitis is a cutaneous phototoxic eruption caused by the interaction of furocoumarins found in some common plants with solar UVA radiation. It is a common skin complaint in travelers to tropical regions. Approximately 24 hours after plant contact with subsequent exposure to sunlight, a burning erythema develops. Limes, other citrus fruits, celery, figs, meadow grass, certain weeds, and oil of bergamot are frequently causative. Exposure to the plant sap of wild parsnip (Pastinaca sativa; "poison parsnip"), common throughout the United States, can cause severe phytophotodermatitis (when in bloom it looks similar to Queen Anne's lace or dill plant and grows to around 4 feet tall). Common scenarios include squeezing limes outdoors, gardening and agricultural work, and hiking or biking in areas of causative plants.
There is no predilection for any age or ethnicity or either sex, although phytophotodermatitis may be more noticeable in lighter skin phototypes. Bartenders and revelers handling citrus fruits are at higher risk. The condition is benign and self-limited, and treatment is supportive.
The term "Berloque dermatitis" refers to phytophotodermatitis from natural oil of bergamot in perfumes. This eruption is typically seen on the face and neck of women applying aerosolized fragrances. This has become rare since the introduction of artificial oil of bergamot.
Related topic: Hogweed dermatitis
There is no predilection for any age or ethnicity or either sex, although phytophotodermatitis may be more noticeable in lighter skin phototypes. Bartenders and revelers handling citrus fruits are at higher risk. The condition is benign and self-limited, and treatment is supportive.
The term "Berloque dermatitis" refers to phytophotodermatitis from natural oil of bergamot in perfumes. This eruption is typically seen on the face and neck of women applying aerosolized fragrances. This has become rare since the introduction of artificial oil of bergamot.
Related topic: Hogweed dermatitis
Codes
ICD10CM:
L56.2 – Photocontact dermatitis [berloque dermatitis]
SNOMEDCT:
238521005 – Phytophotodermatitis
L56.2 – Photocontact dermatitis [berloque dermatitis]
SNOMEDCT:
238521005 – Phytophotodermatitis
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Phototoxic reaction due to another cause (eg, medication-induced phototoxic reaction)
- Immunobullous disease (eg, bullous pemphigoid)
- Erythema multiforme (early stage)
- Fixed drug reaction (late stage and if limited to 1-3 lesions)
- Contact dermatitis
- Heat or chemical burn (see thermal or electrical burn; chemical burns are covered separately, by chemical agent)
- Physical abuse – Handprint or drip patterns are sometimes seen.
- Sunburn
- Porphyria cutanea tarda
- Cnidaria stings (jellyfish sting) or other marine envenomation
- Factitial dermatitis
- Cultural practices
- Pseudoporphyria
- Flagellate erythema and hyperpigmentation from bleomycin toxicity
- Post-inflammatory hyperpigmentation occurs over a longer time frame.
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Therapy
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References
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Last Updated:04/19/2018

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